Metaxa Cancer Hospital, Piraeus, Greece.
Technological Educational Institution of Athens, Athens, Greece.
Folia Med (Plovdiv). 2020 Sep 30;62(3):438-443. doi: 10.3897/folmed.62.e47920.
The change in life expectancy affects the clinical presentation and the prognosis of elderly patients with gynecological cancer. The in-crease of life expectancy and increased numbers of elderly patients, the healthcare systems have to deal more frequently with patients who are not simply older adults but have also severe comorbidities and physiological, psychological, functional, and social needs that require individualised management. Discussing every individual after detailed assessment in a multidisciplinary meeting is extremely important. Several studies have shown that elderly patients with gynecological malignancies are not treated to the same extent as young-er patients and have lower odds of receiving standard care according to the oncological protocols. Individualization of management in these patients could be identified in several studies in the literature showing that increasing age at diagnosis predicts deviation from guidelines for surgical therapy, adjuvant radiotherapy or chemotherapy. The authors performed a literature review to clarify whether there are any changes in the treatment of such patients, and whether their management should be considered to be individualized, depending on their age and comorbidities.
预期寿命的变化会影响妇科癌症老年患者的临床表现和预后。随着预期寿命的延长和老年患者数量的增加,医疗保健系统必须更频繁地应对不仅年龄较大而且还患有严重合并症以及生理、心理、功能和社会需求的患者,这些需求需要个体化管理。在多学科会议上对每位患者进行详细评估非常重要。多项研究表明,妇科恶性肿瘤老年患者的治疗程度不如年轻患者,并且根据肿瘤学方案接受标准治疗的可能性较低。文献中的几项研究表明,这些患者的个体化管理可以确定,即诊断时年龄的增加预示着手术治疗、辅助放疗或化疗方案的偏离。作者进行了文献回顾,以阐明是否对这些患者的治疗有任何改变,以及是否应根据其年龄和合并症考虑对其进行个体化管理。